A devastating complication of ‘skin popping’

Introduction: Krokodil use was first reported in siberia in 2002. the drug derives its name from the harms associated with its use, such as ulcerations and discolored necrotic scaled skin which may resemble crocodile skin. It has also been described as "flesh eating", as it finally disrupts the skin leaving the bone and muscle exposed to infections. case report: A 27-year-old female with past medical history of intravenous opioid dependence for 5-6 years and gastroesophageal reflux disease who presented with ulcerations of the posterior aspects of her arms bilaterally. the patient reported injecting krokodil for the past 5-6 months. she had been observing blue and black discoloration of the skin 1-2 days after each injection for the past 4-5 months. the injection site scabbed after 2-3 days. the patient continued injecting in area next to the affected sites. Eventually the affected sites coalesced and evolved into a large scab containing black necrotic tissue. In the last 5-6 days the black necrotic tissue started peeling off made the underlying tissue visible with mild

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“…In addition to medical and physical attention patients also require emotional and social support [12].…”

Section: Discussionmentioning

confidence: 99%

New case of krokodil (desomorphine) use

Caldararo¹,

Rad²,

Laborde³

et al. 2018

Int J Case Rep Images

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“…Among the world's population, approximately 16 million people between the ages of 15-64 inject illicit drugs on a regular basis [1]; 669,000 Americans reported using heroin in 2012 [2]. Subcutaneous or intramuscular injection is an increasingly popular method of drug abuse and is a major risk factor for soft tissue, bone, and systemic infection [3].…”

Section: Introductionmentioning

confidence: 99%

“…The most commonly injected drug is heroin, although any water-soluble drug may be injected. The onset of effects is approximately 15-30 s for the intravenous delivery and approximately 3-5 min for the intramuscular or subcutaneous administration [1]. Injection can result in abscess formation and infection when pathogens and other contaminants are introduced via shared needles, impurities within the drug, and lack of sterile preparation.…”

Section: Introductionmentioning

confidence: 99%

“…Injection can result in abscess formation and infection when pathogens and other contaminants are introduced via shared needles, impurities within the drug, and lack of sterile preparation. Manifestations due to the toxic effects of a heroin can include respiratory depression, coma, pulmonary edema, and cardiac dysrhythmias which may lead to myocardial infarction, cerebrovascular accident, end-organ damage due to insoluble contaminants, and death [1][2][3]. The death rate from heroin overdose doubled in 28 states from 2010 to 2012, including Ohio [4], the state of our institution.…”

Section: Introductionmentioning

confidence: 99%

“…A common complication of skin popping is the development of subcutaneous abscess which can lead to ulceration. This ulcerative lesion is called a "shooter's patch" which is maintained as the granulation tissue is utilized as a means of injecting illicit drugs [1]. A 2000 study evaluated illicit drug users for the prevalence of abscess and cellulitis.…”

Section: Introductionmentioning

confidence: 99%

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